Background Despite the fact that stress may be associated with adverse psychological effects, there are no validated scales to measure stress among Sri Lankan adolescents. Objectives To develop and validate a scale (SSI) to measure stress among students aged 15 to 19 years in Sri Lanka. Methods In-depth interviews and focus group discussions were conducted among adolescents, in order to explore physical symptoms and thoughts experienced and their behavioural responses, when faced with challenging problems and situations. Following this, a brief, self-administered instrument, the Stress Sensation Inventory (SSI) was developed by a group of experts. The SSI was then validated among 127 school-going adolescents, and the scores were compared with the GHQ30 score and the clinical assessments carried out by a psychiatrist. The cutoff point was determined using the receiver operator characteristic (ROC) curve. Results Cronbach's alpha reliability of the SSI score was 0.8319. The reliability of the psychological, psychosomatic, emotional, and cognitive subscales were 0.7931, 0.6323, 0.6389 and 0.7439 respectively. Measures of validity were satisfactory, with a sensitivity of 84%, specificity of 72%, positive predictive value of 62%, and negative predictive value of 90%. The Kappa agreement between the SSI and GHQ 30 was fair (0.35). Conclusion The SSI is an acceptable, easy to use instrument for measuring stress in school-going adolescents in Sri Lanka. It fulfils stringent criteria of reliability and validity.

Introduction:Mania is a syndrome characterized by elevation of mood, increased activity and self important ideas. Inflated self-esteem may develop into grandiose delusions and suspiciousness into delusions of persecution. Grandiose delusions can be classified into three types. They are delusions of grandiose ability, grandiose identity and religious delusions. Studies on the content of the grandiose delusions and other psychopathology in patients with mania in Sri Lanka is scarce.Aims:To analyze the behavior and psychopathology in patients with maniaMethods:Descriptive cross sectional study. All patients admitted to University Psychiatry Unit, National Hospital of Sri Lanka (NHSL) who met ICD 10 criteria of first episode mania and Bipolar Affective Disorder, current episode manic, within a period of three months were selected. Interviewer administered questionnaire and clinical records were used.Results:Sample was 36. Twenty two (61.1%) had manic episode with psychotic symptoms. Thirteen (36.1%) had destructive behaviour. Thirty three (91.6%) did not show sexual disinhibition. Eighteen (50%) had grandiose delusions. Of the grandiose delusions 10 (55.5%) were of grandiose ability, 6 (33.3%) were of grandiose identity and 2 (11.1%) were of the religious subtype. Five (50%) who had delusion of grandiose ability believed they had healing power. Eleven (30.5%) had persecutory delusions and seven (19.4%) had delusions of reference. Five (13.8%) had auditory hallucinations.Conclusions:Grandiose delusions were the commonest type of delusion but almost one third had persecutory delusions. Most common subtype of grandiose delusion was grandiose ability. Most common content of grandiose ability was healing power.

To analyse the side effects experienced by patients who are on clozapine for a period of more than one year and to analyse the impact of the side effects. Methods A descriptive cross sectional study carried out in University Psychiatry unit, National Hospital of Sri Lanka, Colombo. All patients attending the clozapine clinic within one month and who are on clozapine for a period of more than one year and who are in remission were selected. Interviewer administered questionnaire was used to assess the presence of side effects and their impact. Data was analyzed using SPSS software. Results Sample was 63. Mean age was 34.9 years (range 18-60). Mean duration of usage of clozapine is 7.0 years (range 1-20). Fifty seven (71.4%) had hyper-salivation and constipation and 12 (19.0%) had nocturnal enuresis. Majority of patients who had hyper-salivation (86.6%) and nocturnal enuresis (100%) were not receiving any medical intervention. Fifteen (23.8%) reported the side effects have caused distress for them and 19% (n=12) revealed they have affected their activities of daily living. Conclusions Most common long term side effects were hyper-salivation and constipation. Majority of patients with hypersalivation were not receiving medical intervention. Majority of patients did not report that the side effects affect their activities of daily living or they cause personal distress.

BackgroundFirst episode psychosis (FEP) is the first episode of a psychiatric illness with psychotic symptoms. Delay in diagnosis increases the duration of untreated psychosis (DUP) and leads to poorer outcome.

ObjectivesTo establish any association between urinary tract infections and acute episodes of schizophreniaMethodsA Case control study conducted in University Psychiatry unit, National Hospital of Sri Lanka (NHSL), Colombo, Sri Lanka.Thirty four cases with acute episode of schizophrenia and 30 normal controls matched for age and gender were selected. Cases were patients who met the International Classification of Disease (ICD- 10) criteria to diagnose schizophrenia who attended the inward and outpatient care of the unit. Urine full report (UFR) and urine culture were performed in all cases and controls to detect and confirm urinary tract infections (UTI). Data was analyzed using SPSS software.ResultsNumber of cases was 34 and controls were 30. Mean age of cases was 34.8 years while in controls it was 34.1 years. In cases 18 (52.9%) were males and in controls, 16 (53,3%) were males. Among patients who had acute episodes of schizophrenia 5 (14.7%) became positive for UFR and from controls 2 (6.6%) became positive. (Odds ratio=2.4). Urine culture was positive in 1 case and 1 control each. (Odds ratio=0.88).ConclusionsPatients with acute schizophrenia are more likely to have positive urine full report than normal healthy controls. But they are not more likely to experience urinary tract infections than the normal healthy controls during their acute episode of schizophrenia.